Department of Management, Policy, and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Value Health. 2021 Dec;24(12):1720-1727. doi: 10.1016/j.jval.2021.07.007. Epub 2021 Sep 10.
Studies face challenges with missing 5-level EQ-5D (EQ-5D-5L) data, often because of the need for longitudinal EQ-5D-5L data collection. There is a dearth of validated methodologies for dealing with missing EQ-5D-5L data in the literature. This study, for the first time, examined the possibility of using retrospectively collected EQ-5D-5L data as proxies for the missing data.
Participants who had prospectively completed a 3rd month postdischarge EQ-5D-5L instrument (in-the-moment collection) were randomly interviewed to respond to a 2nd "retrospective collection" of their 3rd month EQ-5D-5L at 6th, 9th, or 12th month after hospital discharge. A longitudinal single imputation was also used to assess the relative performance of retrospective collection compared with the longitudinal single imputation. Concordances between the in-the-moment, retrospective, and imputed measures were assessed using intraclass correlation coefficients and weighted kappa statistics.
Considerable agreement was observed on the basis of weighted kappa (range 0.72-0.95) between the mobility, self-care, and usual activities dimensions of EQ-5D-5L collected in-the-moment and retrospectively. Concordance based on intraclass correlation coefficients was good to excellent (range 0.79-0.81) for utility indices computed, and excellent (range 0.93-0.96) for quality-adjusted life-years computed using in-the-moment compared with retrospective EQ-5D-5L. The longitudinal single imputation did not perform as well as the retrospective collection method.
This study demonstrates that retrospective collection of EQ-5D-5L has high concordance with "in-the-moment" EQ-5D-5L and could be a valid and attractive alternative for data imputation when longitudinally collected EQ-5D-5L data are missing. Future studies examining this method for other disease areas and populations are required to provide more generalizable evidence.
研究面临缺失 5 级 EQ-5D（EQ-5D-5L）数据的挑战，这通常是因为需要进行纵向 EQ-5D-5L 数据收集。文献中缺乏处理缺失 EQ-5D-5L 数据的经过验证的方法。本研究首次探讨了使用回顾性收集的 EQ-5D-5L 数据作为缺失数据替代值的可能性。
前瞻性完成第 3 个月出院后 EQ-5D-5L 仪器（即时采集）的参与者被随机访谈，以回答出院后第 6、9 或 12 个月的第 3 个月 EQ-5D-5L 的第 2 次“回顾性采集”。还使用纵向单插补来评估回顾性采集与纵向单插补的相对性能。使用组内相关系数和加权 kappa 统计评估即时、回顾和插补测量之间的一致性。
基于加权 kappa（范围 0.72-0.95），在即时和回顾性收集的 EQ-5D-5L 的移动性、自我护理和日常活动维度之间观察到相当大的一致性。基于组内相关系数的一致性为良好至优秀（范围 0.79-0.81），用于计算效用指数，并且在使用即时与回顾性 EQ-5D-5L 计算质量调整生命年时为优秀（范围 0.93-0.96）。纵向单插补的表现不如回顾性采集方法。
本研究表明，回顾性收集 EQ-5D-5L 与“即时”EQ-5D-5L 具有高度一致性，当纵向收集的 EQ-5D-5L 数据缺失时，可能是一种有效且有吸引力的数据插补替代方法。需要进行其他疾病领域和人群的研究来提供更具普遍性的证据。
